{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T13:05:38Z","timestamp":1791464738693,"version":"4.3.4"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T00:00:00Z","timestamp":1715904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>To investigate what pre-treatment clinical-pathological features and MRI characteristics influence the performance of breast MRI in assessing the pathologic complete response (pCR) of breast cancer patients to Neoadjuvant Chemotherapy (NAC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 225 patients with pathologically-confirmed breast cancer who underwent pre- and post-NAC breast MRI between January 2020 and April 2023 were retrospectively analyzed. All patients were categorized into radiologic complete response (rCR) and non-rCR groups based on pre-operative MRI. Univariable and multivariable logistic regression were used to identify independent clinicopathological and imaging features associated with imaging-pathological discordance. The performance of pre-operative MRI for predicting pCR to NAC was assessed according to the baseline characteristics of the clinicopathological data and pre-NAC MRI. In addition, the discrepancy between the pre-operative MRI and post-operative pathological findings was further analyzed by a case-control approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 225 patients, 99 (44.0%) achieved pCR after NAC. MRI showed the overall sensitivity of 97.6%, specificity of 58.6%, accuracy of 80.4%, a positive predictive value (PPV) of 75.0%, and a negative predictive value (NPV) of 95.1% in identifying pCR. Of baseline features, presence of ductal carcinoma <jats:italic>in situ<\/jats:italic> (DCIS) (OR, 3.975 [95% CI: 1.448\u201310.908], <jats:italic>p<\/jats:italic> = 0.007), luminal B (OR, 5.076 [95% CI: 1.401\u201318.391], p = 0.013), HER2-enriched subtype (OR, 10.949 [95% CI: 3.262\u201336.747], <jats:italic>p<\/jats:italic> &amp;lt; 0.001), multifocal or multicentric lesions (OR, 2.467 [95% CI: 1.067\u20135.706], <jats:italic>p<\/jats:italic> = 0.035), segmental or regional distribution of NME (OR, 8.514 [95% CI: 1.049\u201369.098], <jats:italic>p<\/jats:italic> = 0.045) and rim enhancement of mass (OR, 4.261 [95% CI: 1.347\u201313.477], <jats:italic>p<\/jats:italic> = 0.014) were significantly associated with the discrepancy between MRI and pathology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Presence of DCIS, luminal B or HER2-enriched subtype, multicentric or multifocal lesions, segmental or regional distribution of NME and rim enhancement of mass may lead to a decrease in diagnostic accuracy of MRI in patients of breast cancer treated with NAC.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2024.1366613","type":"journal-article","created":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T04:31:32Z","timestamp":1715920292000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Pre-operative MRI in evaluating pathologic complete response to neoadjuvant chemotherapy in patients with breast cancer: a study focused on influencing factors of baseline clinical-pathological and imaging 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